Short- and Long-Term Mortality and Mortality Risk Factors among Nursing Home Patients after COVID-19 Infection.

Abstract

OBJECTIVE:

To assess short- and long-term mortality and risk factors in nursing home patients with COVID-19 infection.

DESIGN:

Retrospective 2-center cohort study.

SETTING AND PARTICIPANTS:

Dutch nursing home patients with clinically suspected COVID-19 infection confirmed by reverse transcription-polymerase chain reaction testing.

METHODS:

Data were gathered between March 2020 and November 2020 using electronic medical records, including demographic characteristics, comorbidities, medical management, and symptoms on the first day of suspected COVID-19 infection. Mortality at 30 days and 6 months was assessed using multivariate logistic regression models and Kaplan-Meier analysis. At 6 months, a subgroup analysis was performed to estimate the mortality risk between COVID-negative patients and patients who survived COVID-19. Risk factors for mortality were assessed through multivariate logistic regression models.

RESULTS:

A total of 321 patients with suspected COVID-19 infection were included, of whom 134 tested positive. Sixty-two patients in the positive group died at 30 days, with a short-term mortality rate of 2.9 (95% CI 1.7-5.3). Risk factors were fatigue (OR 2.6, 95% CI 1.3-6.2) and deoxygenation (OR 2.9, 95% CI 1.3-7.6). At 6 months, the mortality risk was 2.1 (95% CI 1.3-3.7). Risk factors for 6-month mortality were shortness of breath (OR 2.7, 95% CI 1.3-7.0), deoxygenation (OR 2.5, 95% CI 1.1-6.5) and medical management (OR 4.5, 95% CI 1.7-25.8). However, among patients who survived COVID-19 infection, the long-term mortality risk was not sustained (OR 1.0, 95% CI 0.4-2.7).

CONCLUSIONS AND IMPLICATIONS:

Overall, COVID-19 infection increases short- and long-term mortality risk among nursing home patients. However, this study shows that surviving COVID-19 infection does not lead to increased mortality in the long term within this population. Therefore, advanced care planning should focus on quality of life among nursing home patients after COVID-19 infection.

• Authors: Johannes A Booij, Julie C H Q van de Haterd, Sanne N Huttjes, Rogier H P D van Deijck, Raymond T C M Koopmans
• Journal: Journal of the American Medical Directors Association (J Am Med Dir Assoc) Vol. 23 Issue 8 Pg. 1274-1278 (08 2022) ISSN: 1538-9375 [Electronic] United States
• PMID: 35809633 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Topics

• COVID-19
• Cohort Studies
• Humans
• Nursing Homes
• Quality of Life
• Retrospective Studies
• Risk Factors
• SARS-CoV-2